Chatfield S M, Brand C, Ebeling P R, Russell D M
Department of General Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Intern Med J. 2007 Jun;37(6):377-82. doi: 10.1111/j.1445-5994.2007.01339.x.
Vitamin D deficiency is common in various populations worldwide. Adverse effects of vitamin D deficiency are the development of bone disorders; however, other diseases such as multiple sclerosis, type 1 diabetes, rheumatoid arthritis and certain cancers have also been linked to vitamin D deficiency. The general medical inpatient population is a group at increased risk of vitamin D deficiency. These patients often have coexistent risk factors for its consequences. This study aims to document a point prevalence of vitamin D deficiency in this population.
Two cross-sectional audits of patients admitted to general medicine units were carried out--the first in mid-November at the end of winter and the second in mid-April and May at the end of summer. Information regarding patients' comorbidities, medication usage, previous falls and fractures was obtained and serum 25-hydroxyvitamin D, parathyroid hormone and calcium levels were measured.
A total of 129 patients was studied (65 in winter and 64 in summer). Ninety-four patients (74%) had 25-hydroxyvitamin D levels < or = 50 nmol/L. Seven patients had severe deficiency (levels < or = 12.5 nmol/L). Average vitamin D levels were lower at the end of winter (35 vs 43 nmol/L, P = 0.007). Of the 37 patients receiving vitamin D supplements, 20 (54%) had 25-hydroxyvitamin D levels < or = 50 nmol/L.
Low vitamin D levels were common in this general medical inpatient population. The average vitamin D level was lower in the patient group tested in November following winter. Supplementation of vitamin D did not uniformly prevent deficiency.
维生素D缺乏在全球不同人群中普遍存在。维生素D缺乏的不良影响是引发骨骼疾病；然而，其他疾病如多发性硬化症、1型糖尿病、类风湿性关节炎和某些癌症也与维生素D缺乏有关。普通内科住院患者群体是维生素D缺乏风险增加的人群。这些患者通常并存其后果的风险因素。本研究旨在记录该人群中维生素D缺乏的点患病率。
对入住普通内科病房的患者进行了两次横断面审计——第一次在冬季末的11月中旬，第二次在夏季末的4月中旬和5月。获取了有关患者合并症、用药情况、既往跌倒和骨折的信息，并测量了血清25-羟维生素D、甲状旁腺激素和钙水平。
共研究了129例患者（冬季65例，夏季64例）。94例患者（74%）的25-羟维生素D水平≤50 nmol/L。7例患者严重缺乏（水平≤12.5 nmol/L）。冬季末的平均维生素D水平较低（35 vs 43 nmol/L，P = 0.007）。在37例接受维生素D补充剂的患者中，20例（54%）的25-羟维生素D水平≤50 nmol/L。
在这个普通内科住院患者群体中，维生素D水平低很常见。在冬季后的11月测试的患者组中，平均维生素D水平较低。补充维生素D并不能一致地预防缺乏。
